Pleuropulmonary blastoma with vascular invasion.

Cerebral metastasis and other central nervous system complications of pleuropulmonary blastoma

“…For most sarcomas, the incidence of cerebral metastasis is 5% or less 35–41; in clear cell sarcoma of kidney, it may be between 5–11% 42,43. A possible factor predisposing PPB to cerebral metastasis may be gross tumor extension into thoracic great vessels and the heart 44–47 allowing tumor access to the arterial circulation. As noted above, tumor embolism 25,32 has occurred in literature and Registry cases.…”

“…Embolism of PPB to cerebral vessels has been inferred from post‐operative cerebrovascular accidents 21,25,32, and in one such case, femoral artery embolism was confirmed pathologically. PPB extensions have been demonstrated echocardiographically in the right pulmonary artery, right pulmonary vein, left atrium and/or tricuspid valve orifice, the azygous vein, superior vena cava, and right atrium 44–47. Unlike Wilms tumor propagating in vessels entering the right side of the heart, PPB may extend to additional thoracic vascular circuits allowing arterial embolization.…”

Pleuropulmonary Blastoma

“…13 PPB tumor can invade the great vessels and can sometimes present with superior vena cava syndrome. [15][16][17] Because the primary involves lung parenchyma, tumor embolization into the arterial circulation may occur during surgical manipulation. Similar to patient #10, other reports describe postoperative cerebral infarcts followed by the development of cerebral metastases.…”